How much rates vary
Facilitymedian $562 · 10th to 90th $288 to $4,169Professionalmedian $661 · 10th to 90th $347 to $1,585
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $912.01 Median $2,691.53 Typical High $3,715.35 | Facility | None | $912.01 | $2,691.53 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $912.01 | Professional | None | $281.84 | $436.52 | $912.01 |
AllWays Health Partners Setting Facility Modifier None Typical Low $416.87 Median $2,041.74 Typical High $5,623.41 | Facility | None | $416.87 | $2,041.74 | $5,623.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $380.19 Median $741.31 Typical High $3,311.31 | Professional | None | $380.19 | $741.31 | $3,311.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $758.58 | Facility | None | $331.13 | $398.11 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $524.81 Typical High $831.76 | Facility | None | $426.58 | $524.81 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $1,122.02 | Professional | None | $407.38 | $602.56 | $1,122.02 |
Fallon Health Setting Facility Modifier None Typical Low $177.83 Median $398.11 Typical High $3,311.31 | Facility | None | $177.83 | $398.11 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $776.25 | Professional | None | $575.44 | $676.08 | $776.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,754.40 | Facility | None | $977.24 | $2,290.87 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $380.19 Median $741.31 Typical High $1,318.26 | Professional | None | $380.19 | $741.31 | $1,318.26 |
Health New England Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Health New England Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Mass General Brigham Setting Facility Modifier None Typical Low $416.87 Median $2,041.74 Typical High $5,623.41 | Facility | None | $416.87 | $2,041.74 | $5,623.41 |
Mass General Brigham Setting Professional Modifier None Typical Low $380.19 Median $741.31 Typical High $3,311.31 | Professional | None | $380.19 | $741.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,344.23 Typical High $6,309.57 | Facility | None | $1,047.13 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $380.19 Median $616.60 Typical High $1,380.38 | Professional | None | $380.19 | $616.60 | $1,380.38 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $537.03 | Facility | None | $239.88 | $346.74 | $537.03 |
Well Sense Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $380.19 | Professional | None | $223.87 | $302.00 | $380.19 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $218.78 Typical High $457.09 | Professional | 52 · Reduced service | $141.25 | $218.78 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $87.10 Typical High $181.97 | Professional | 53 · Discontinued | $56.23 | $87.10 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $331.13 Typical High $676.08 | Professional | 54 · Surgery only | $213.80 | $331.13 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $66.07 Typical High $134.90 | Professional | 55 · Aftercare only | $42.66 | $66.07 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $43.65 Typical High $91.20 | Professional | 56 · Pre-op care only | $28.18 | $43.65 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $309.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $199.53 | $309.03 | $630.96 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $204.17 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $144.54 | $204.17 | $275.42 |
Where Massachusetts sits
The same service costs 4.5 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 9th of 51
$661
AK $1,259TX $282
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.